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1.  Vitamin C may have similar beneficial effects to Gemfibrozil on serum high-density lipoprotein-cholesterol in type 2 diabetic patients 
Objective:
Type 2 diabetes mellitus (DM-T2) is commonly associated with increased triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C) levels. Fibrates like gemfibrozil are frequently used in diabetic patients to decrease TG and increase HDL-C levels. We compared the efficacy of Vitamin C, an antioxidant vitamin, with gemfibrozil on serum HDL-C in diabetic patients.
Methods:
Type 2 diabetic patients, referred to our out-patient clinic were randomly divided into three groups. After 1 month of lifestyle and diet modifications, groups A, B, and C were prescribed 1000 mg Vitamin C, 600 mg gemfibrozil and combination of both, respectively. Before the study initiation and after 6th week of drug prescription, the blood samples were taken and analyzed for total cholesterol (Total-C), HDL-C, TG, fasting blood sugar (FBS), and hemoglobin A1c (HbA1c) levels.
Findings:
Sixty-seven patients entered, and 50 patients (18 male, 32 female) finished the study. Overall, serum HDL-C increased significantly from 39.8 to 45.2 mg/dL in the participants (P = 0.001). HDL-C increased 6.3, 4.4 and 5.0 mg/dL in groups A, B and C, respectively (related significances were 0.017, 0.022 and 0.033, respectively). Significant decrease of serum TG and Total-C occurred in gemfibrozil and combination groups, but not in Vitamin C group. Changes in serum HDL-C between three groups were not significant (P = 0.963). We found a significant decrease in TG and Total-C in the groups B and C (P < 0.05), but no significant changes of TG, Total-C, LDL-C, FBS and HbA1c in group A (P > 0.05).
Conclusion:
The results demonstrated that Vitamin C may have beneficial effects on HDL-C in diabetic patients without significant effects on plasma glucose or other lipid parameters; however, its role for the treatment of low HDL-C patients should be evaluated in larger studies.
doi:10.4103/2279-042X.141075
PMCID: PMC4199195  PMID: 25328896
Diabetes mellitus; Gemfibrozil; high-density lipoprotein cholesterol; Vitamin C
3.  How does the impact of a community trial on cardio-metabolic risk factors differ in terms of gender and living area? Findings from the Isfahan healthy heart program 
Objective:
To assess the impact of gender and living area on cardiovascular risk factors in the context of a comprehensive lifestyle intervention program.
Design:
Data from independent sample surveys before (2000--2001) and after (2007) a community trial, entitled the Isfahan Healthy Heart Program (IHHP) were used to compare differences in the intervention area (IA) and reference area (RA) by gender and living area.
Setting:
The interventions targeted the population living in Isfahan and Najaf-Abad counties as IA and Arak as RA.
Participants:
Overall, 12 514 individuals who were more than 19 years of age were studied at baseline, and 9570 were studied in postintervention phase.
Interventions:
Multiple activities were conducted in connection with each of the four main strategies of healthy nutrition, increasing physical activity, tobacco control, and coping with stress.
Main Outcomes:
Comparing serum lipids levels, blood pressure, blood glucose and obesity indices changes between IA and RA based on sex and living areas during the study.
Results:
In IA, while the prevalence of hypertension declined in urban and rural females (P < 0.05). In IA, the prevalence of hypercholesterolemia and hypertriglyceridemia decreased in both females and males of urban and rural areas except for hypercholesterolemia in rural males (P < 0.01). In RA, the significant changes include both decrease in the hypercholesterolemia among rural males (P < 0.001) and hypertriglyceridemia in urban females (P < 0.01), while hypertriglyceridemia was significantly increased in rural females (P < 0.01).
Conclusions:
This comprehensive community trial was effective in controlling many risk factors in both sexes in urban and rural areas. These findings also reflect the transitional status of rural population in adopting urban lifestyle behaviors.
PMCID: PMC3687879  PMID: 23798939
Age; cardiovascular risk factor; community health program; health promotion; rural; sex; urban
4.  Correlation between microalbuminuria and urinary copper in type two diabetic patients 
Introduction:
Diabetes mellitus and its chronic complications may be associated with alterations in the plasma, tissue, and urinary levels of some trace elements like copper.
Materials and Methods:
This cross-sectional study evaluates the 24 hour urinary copper levels in type 2 diabetic patients with microalbuminuria in comparison with patients without albuminuria.
Results:
Forty-two patients with microalbuminuria (case) and 40 patients without microalbuminuria (control) participated in the study. Mean (CI 95%) urinary copper levels were 36.14 (14.54–57.74) and 14.77μcg /L (10.17–19.37) in the case and control groups respectively (P = 0.003). There was no significant effect of diabetes duration or HbA1c on urinary copper.
Conclusion:
The present study shows diabetic patients with microalbuminuria have increased urinary copper excretion, however does not exclude the potential toxic effects of this high copper excretion on the progression of diabetic nephropathy.
doi:10.4103/2230-8210.85586
PMCID: PMC3193781  PMID: 22029003
Albuminuria; copper; diabetes mellitus; nephropathy; trace elements
5.  The efficacy of topical Royal Jelly on diabetic foot ulcers healing: A case series* 
BACKGROUND:
Foot ulcers and infections are the major sources of morbidity in individuals with diabetes mellitus. This study aimed to evaluate the efficacy of topical Royal Jelly (a worker honey bee product) on healing diabetic foot ulcers.
METHODS:
Diabetic patients with foot ulcers that were referred to our clinic at Khorshid Hospital, Isfahan, Iran; were evaluated three times a week and treated according to standard treatments consisted of offloading, infection control, vascular improvement and debridement if required. In addition, all ulcers were measured and then topical sterile 5% Royal Jelly was applied on the total surface area of the wounds. Eventually, they were covered with sterile dressings. Each patient was followed for a period of three months or until the complete healing.
RESULTS:
A total of eight patients were enrolled in this study. Of these, two had two ulcers and, therefore, ten ulcers were evaluated. Two ulcers were excluded. Seven of the remained eight ulcers healed. Mean duration of complete healing was 41 days. One ulcer did not completely heal but improved to 40% smaller in length, 32% in width and 28% in depth. The mean length, width and depth reduction rates were 0.35 mm/day, 0.28 mm/day and 0.11 mm/day, respectively.
CONCLUSIONS:
Royal Jelly dressing may be an effective method for treating diabetic foot ulcers besides standard treatments.
PMCID: PMC3263103  PMID: 22279458
Diabetic foot ulcer; Royal Jelly; Offloading; Debridement
6.  A patient with refractory testicular adrenal rest tumour in the setting of cyp11b1 deficiency congenital adrenal hyperplasia 
BMJ Case Reports  2009;2009:bcr06.2008.0280.
Testicular adrenal rest tumour (TART) due to CYP11B1 deficiency is a very rare clinical finding. Only seven cases have been reported previously. Here, the case of a 19-year-old boy with classic CYP11B1 deficiency and large testicles refractory to medical treatment that led to orchidectomy is reported. The clinical and laboratory manifestations of this patient are discussed and compared with that of the previously reported cases. The patient presented with rapid body growth, precocious puberty, hypertension, recurrent hypokalaemic paralysis and testicular enlargement. The most important differential diagnosis of his latter presentation is Leydig cell tumour (LCT). It was found that positive family history of congenital adrenal hyperplasia (CAH), hypertension, bilaterality, hypokalaemia and multiple hypoechoic masses on ultrasonography of the testes are in favour of a diagnosis of TART. Conversely, high titres of tumour markers and presence of Reinke crystalloids are supportive of a diagnosis of LCT.
doi:10.1136/bcr.06.2008.0280
PMCID: PMC3028312  PMID: 21686875
7.  Association between Serum Ferritin and Goitre in Iranian School Children 
Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region.
PMCID: PMC2980875  PMID: 20411676
Cross-sectional studies; Goitre; Iodine; Iron deficiency; Serum ferritin; Iran

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